eDOTS: Improving the Treatment of Pulmonary Tuberculosis in Xinjiang, China

Gang Guo; Yanling Zheng; Xuexian Ma; Li Sun; Qimanguli Wushouer; Bin Jia; Muladier Yusufu; Shu Wen; Tuerhong Abudureyimu; Xiaowang Peng; Zhenjiang Liu; Xirizat Mamut; Yanggui Chen; Jian Zhang; Yuling Yang; Liusheng Huangfu; Jun Li; Wenbao Zhang

doi:10.2147/IDR.S438962

eDOTS: Improving the Treatment of Pulmonary Tuberculosis in Xinjiang, China

Infect Drug Resist. 2023 Dec 7:16:7497-7505. doi: 10.2147/IDR.S438962. eCollection 2023.

Authors

Gang Guo^#^{1

2}, Yanling Zheng^#³, Xuexian Ma⁴, Li Sun⁵, Qimanguli Wushouer¹, Bin Jia¹, Muladier Yusufu⁵, Shu Wen⁶, Tuerhong Abudureyimu⁶, Xiaowang Peng⁶, Zhenjiang Liu⁶, Xirizat Mamut⁶, Yanggui Chen⁷, Jian Zhang⁸, Yuling Yang⁹, Liusheng Huangfu⁹, Jun Li¹, Wenbao Zhang¹

Affiliations

¹ State Key Laboratory Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asian, First Affiliated Hospital of Xinjiang Medical University, Urumqi, People's Republic of China.
² Suzhou Center for Disease Control and Prevention, Suzhou, People's Republic of China.
³ College of Medical Engineering and Technology, Xinjiang Medical University, Urumqi, People's Republic of China.
⁴ Shache People's Hospital, Shache, People's Republic of China.
⁵ Yingjisha County Center for Disease Control and Prevention, Yingjisha, People's Republic of China.
⁶ Kashgar Regional Lung Hospital, Kashgar, People's Republic of China.
⁷ Urumqi Municipal Center for Disease Control and Prevention, Urumqi, People's Republic of China.
⁸ High-Tech District Center for Disease Control and Prevention of Urumqi, Urumqi, People's Republic of China.
⁹ Xinhuarui Information Co., LTD, Urumqi, People's Republic of China.

^# Contributed equally.

Abstract

Purpose: To increase pulmonary tuberculosis (PTB) treatment adherence in Xinjiang Region, an electronic DOTS (eDOTS) system developed was applied and evaluated.

Methods: An eDOTS system comprised electronic medicine boxes, mobile phones and a central processing platform. Between April and June 2016, persons with active PTB (PAPTB) were recruited from villages and a city and were prescribed a six-month course of antibiotics using either DOTS or eDOTS. Treatment adherence rate and chest X-ray digital radiography (DR) score were used to evaluate usefulness of eDOTS.

Results: A total 167 PAPTB were recruited with 81 participants from villages and 86 from neighbourhoods. Of the 81 village patients, 43 (53%) used eDOTS and 38 (47%) used DOTS. Among the 86 patients from neighbourhoods, 50 (58%) used eDOTS and 36 (42%) used DOTS. After 6 months of treatment, the average treatment compliance of the village patients who used eDOTS were 47.0%±20.5% compared to 26.7%±21.1% who used DOTS (t=-4.475, p<0.001). The patients using eDOTS from both the villages and city had significantly lower X-ray DR scores than the patients using DOTS by 1.81 points, 95% CI (0.72-2.90) and 1.05 points, 95% CI (0.15-1.95), respectively.

Conclusion: eDOTS is an effective means of managing the treatment of active PTB patients through daily reminding and monitoring of patient compliance. Ease of contact with doctors and special education programs encouraged PAPTB to complete their treatment course as required.

Keywords: drug treatment; infection; prevention/control program; tuberculosis.

Grants and funding

This study was financially supported by the Project of WHO-TDR small grant (201344525), State Key Laboratory of Pathogenesis, Prevention, Treatment of Central Asian High Incidence Diseases Fund (SKL-HIDCA-2021-JH5, SKL-HIDCA- 2021-JH1), Research Program of First Affiliated Hospital of Xinjiang Medical University (SB-2015-02) and the National Natural Science Foundation Project of China (72174175). The grantors were not involved in the study design, analysis or interpretation, or decision to submit this manuscript.